Aldo J. Montano-Loza, M.D., Ph.D., from the University of Alberta Hospital in Canada, and colleagues examined whether VAT is associated with the risk of HCC in patients with cirrhosis and with the risk of HCC recurrence after liver transplantation (LT). Body composition was evaluated for 678 patients with cirrhosis who were assessed for LT. A total of 247 patients underwent LT and were then assessed for body composition; 96 of these patients had HCC.

The researchers found that VATI was higher in male patients with HCC versus non-HCC patients at the time of LT assessment (75±3 versus 60±3 cm²/m²). Compared with non-HCC patients, male patients with HCC had higher VATI, subcutaneous adipose tissue index, and total adipose tissue index. The risk of HCC was elevated for male patients with VATI ≥65 cm²/m² in multivariable analysis (hazard ratio, 1.9). A VATI ≥65 cm²/m² adjusted for Milan criteria was independently associated with an elevated risk of HCC recurrence in male patients with HCC who underwent LT (hazard ratio, 5.34).

"High VATI is a novel and independent risk factor for HCC in male patients with cirrhosis, and for recurrence of HCC after LT," the authors write.